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Conquer Your Weight
Episode #13: You're Not Sleeping Well Enough
May 18, 2022
This week we're going to talk about sleep. Getting good sleep is one of the most important factors in weight loss, as well your overall physical and mental health.
Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight Podcast, episode number 13. Announcer: Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh. Dr. Sarah Stombaugh: Hi everyone. Thank you for joining me today. Today we are going to talk about sleep and getting your beauty rest because I'm gonna go out on a limb here and bet that you are not sleeping well enough. Yep, you. I have hundreds of listeners, some of whom I know personally and most of whom I don't, but I've talked to enough people over the years. I can tell you that most people are sleep, not sleeping well enough. I would guess, honestly, like 90% of the people I talk to are not sleeping well. What does it mean to sleep? Well, it means that you're getting the amount of sleep that your body needs. You have a similar bedtime most nights, and you wake up on your own in the morning without an alarm clock. You sit up, you stretch, you feel like, ah, it's time to get the day started and you feel well rested. And if you're listening and thinking, yes, that sounds exactly like me. I wake up every morning and the birds are chirping and I hum a song as I start my morning routine, then you definitely don't have to listen to today, today's episode, but for all the rest of you, I am talking to you, most of you, those of you who wake up in the morning feeling groggy, those of you who force yourselves out of bed because you have obligations to attend to, those of you who hit the snooze button for nine minutes or 30 minutes or an hour or two hours, those of you who go to bed at one or two or three o'clock in the morning just to turn around and wake up four or five hours later, those of you who sleep in hours later on the weekends, those of you who snore, those of you who don't think you snore but you do, those of you who had bad dreams and nightmares, those of you who sleep restlessly throughout the night, those of you who have trouble falling asleep or wake up in the middle of the night or wake up really a lot earlier than you want to despite feeling too tired. And those of you who rely on caffeine to stay awake throughout the day or take naps throughout the day, if any of those sound like you, I'm talking to you. As with anything in life, we get into habits, good or bad, and a lot of times we don't stop and think about why we're doing the things we're doing. We act as if things happen just because, as if we have no say in our lives. But I'm here to remind you, you and only you are the boss of you. You get to make all of the decisions about your life. And if you're not sleeping well enough, you can fix that. We're going to start today, and I want you to really think about this for yourself. Are there changes you want to make? Why do you want to make those changes? Is this something that you can do on your own or are you going to need the help of a professional? And I want you to start by writing down all of the beliefs or thoughts you regularly have about sleep. This can be anything. The good, the bad, the ugly things like sleep is more important to me than anything else. I love my bed. I sleep terribly. I wish I knew how to sleep better. There's too much for me to do at home or work or whatever. I can't sleep more. I don't have time. I'm so bad about going to bed at night. I should get more sleep. Sleep is for the weak. I'll sleep when I'm dead. No one with good kid, with young kids gets good sleep. And if you are having thoughts like sleep is more important to me than anything else, or I love my bed, excellent, keep doing that. But if you have some or many negative thoughts towards sleep, I want you to stop and question those thoughts. Remember, these are just your thoughts. They are not facts. You may have been thinking these thoughts over and over again for many years, but that doesn't mean they're true. And it doesn't mean that good sleep isn't possible for you. If you've been getting five hours of restless sleep every night for many years, you're likely to have a thought like I sleep terribly. And you can't just exchange that thought for another one like, I love sleeping because that feels completely unbelievable. It feels uncomfortable and untrue, but are you open to believing you could be a better sleeper? Could you instead have a thought like it's possible one day I could learn how to sleep better? Those qualifiers are great. It makes your brain feel more accepting, like, sure, maybe it's possible. And if you are someone who has negative beliefs about sleep, try that thought on, say it out loud. It's possible that one day I could learn to sleep better. You can imagine how these different thoughts play out in our feelings, our actions and the results we get in our lives. If you're having a thought like I sleep terribly, you're likely to feel defeated or a similar emotion. And someone who's thinking I sleep terribly and feels defeated, is unlikely to take steps towards improving their sleep. And then you perpetuate the cycle such that you create a result in your life or you continue sleep terribly. Alternatively, if you try in a thought like it's possible that one day I could learn to sleep better, someone who is thinking a thought like this may feel hopeful or optimistic, they might visit their doctor or talk to a sleep consultant or seek out other resources to learn how to improve their sleep. They begin to create a result where they learn how to sleep better. It's absolutely fascinating how our minds work. We can open or close doors in our lives just by stopping to pause and observe and question the thoughts we're having today. I also want to address sleep hygiene and sleep problems. We're going to talk through some of those problems today, but if we don't address everything um, that you're dealing with, you'll need to see a professional and talk with someone else. And I wanna make sure you take those steps on your own because sleep is so, so important. It's one of the most important things for humans. And really most animals. Sleep is a time of restoration both for our brains and for our bodies. And getting enough sleep is critical, not just for feeling good emotionally, but feeling well physically. Importantly in the role of weight loss, it plays a huge role. If you are someone who occasionally sleeps well and occasionally sleeps poorly, you might even be able to compare and contrast how you feel in relation to hunger or cravings on a day after you've slept well, compared to a day where you've slept poorly. For example, I'm someone who generally sleeps pretty well. Sleep is important to me, and most nights I get enough sleep. I make it a priority because oh my gosh, I can completely tell when I don't. The day after I've slept poorly. I find myself craving foods in general, especially sweet foods, and I find that my tired brain is pretty lazy. It's not that I'm just more likely to crave those foods, but I feel like I'm more likely to consume those foods as well. And this is a fairly unscientific thing to say, but bear with me because I feel like it summarizes why sleep is so important in weight loss. Our bodies are craving energy. The best way for us to obtain that energy may have been via sleep, but when we haven't had enough sleep, we instead turn to things like caffeinated beverage or sweetened food and drink or both in order to give us energy and to demonstrate that same thing more scientifically. Study after study has shown that poor sleep is linked to obesity. We know that there are hormonal changes that occur when we don't get enough sleep, for example, we are more likely to be insulin resistant, and as a result we have higher blood sugar numbers and spend more time in that energy storage mode we've talked about before. We also have an increase in ghrelin, which is our hunger hormone. More ghrelin equals more hunger and a double whammy. We also have decreased levels of leptin. Leptin is our satiety or fullness hormone. If we have less leptin, we have less fullness, meaning we eat a larger amount of food. With all of these changes combined, it's easy to see why poor sleep is associated with weight gain and obesity. Studies that have looked at the correlation between sleep and weight gain have shown that the ideal amount of sleep is seven hours per night. In these studies, people who slept less or people who slept more were more likely to suffer from obesity compared to people who were getting seven hours of night on average. I do wanna point out though you are not a statistic. I want you to set a goal of learning to understand how much sleep you personally need. You need to listen to the messages your body is sending you because I will tell you that I, for one, I can function on seven hours of sleep. I feel okay, but I don't feel great. I feel great when I get eight to nine hours of sleep per night. And when I'm consistently getting eight to nine hours of sleep per night, I honestly wake up feeling like the birds are singing and I'm humming. I feel really good. On the other hand, there is a small percent of the population who are short sleepers. It's about 1% of the population. And short sleepers are people who need less than six hours of sleep per night. They wake up after getting four or five hours of night sleep and they feel alert and they feel refreshed. They feel and function completely normally during the daytime. They don't require caffeine or other stimulants to feel alert or function normally. And for these people that shortened sleep duration occurs completely naturally, and they will sleep less than six hours a night. Even on weekends or holidays, when there's an opportunity for increased sleep, they simply need less sleep. But the reality is that's 1% of people. On the contrast, many, many people who are sleeping less than six hours a night are just getting by. They may have tricked themselves into believing they're doing just fine or that they don't need as much sleep as the average person, but they might be relying on slugging caffeine or taking naps or sleeping in on the weekends to catch up. And if you're having to do these things, you are not a superhuman. You are not a short sleeper. You are a normal person who needs a normal amount of sleep. And I'm so sorry. Sometimes I wish that I could be a short sleeper, but I'm not. I just, I need the amount that I need and I completely acknowledge that. And so in this process, I want you to do the same. I want you to really pay attention to you and focus about how you feel. It's about getting honest with yourself so you can make the best decisions for yourself and your sleep. Let's talk a bit about sleep hygiene. We often blow past these ideas, but if you're not sleeping as well as you could, I want you to stop and really listen. Getting a good night of sleep starts with doing the right things during the daytime and leading up to bed. I can't tell you how many people I've talked to who drink caffeine throughout the day and then they wind down by watching TV in bed until the late hours of the night, and they expect to just magically close their eyes, fall asleep the second their head hits the pillow, have beautiful sleep for seven or eight hours and not have any issues. And maybe that's the case, in which case, great. But if you're waking up feeling tired or you are having any sleep problems at all, you need to start by looking at your sleep hygiene because sleep hygiene is about honoring and protecting your sleep during the daytime. You need to be mindful about things like caffeine, both the amount that you consume and also the timing in which you consuming it. Drinking caffeine can be such a bad cycle because we drink it throughout the day to stay awake. Then it's lingering effects keep us from sleeping well at night and then the next day we need more caffeine because we're feeling tired. Again. On average, caffeine has a half-life of about five hours, meaning that after five hours, your body has processed about half of the caffeine you've consumed. However, that half-life can vary greatly depending on the person. So some people might process caffeine in with a half-life of two hours, where other people might take more than nine hours to process. And all of that to say is you need to be careful with your caffeine consumption. For the majority of people having caffeine out of your body at bedtime means no more than two cups per day all consumed before noon. We need to be careful with things like alcohol as well. Alcohol is a depressant. So many people use it with dinner or in the evenings thinking it might help their sleep. But we know that despite the fact that alcohol makes you tired, it does not contribute to better sleep. In fact, it usually decreases our REM sleep, meaning that even if you're getting the same number of hours of sleep, those are going to be lower quality hours of sleep. And then in our evening hours, it's important to have a good evening and bedtime routine to set ourselves up for good sleep. It will mean limiting screen time in the one or two hours before bed, having a good wind down routine that involves changing your pajamas, your nighttime hygiene routine like brushing your teeth, washing your face, and then a restful activity like reading or prayer or meditation. And you should aim to have a similar bedtime every night to develop the regularity in your sleep hormone regulation. And if right now you're going to bed too late, you might wanna start slowly bumping up your bedtime in 15 or 20 or 30 minute intervals until you eventually reach your desired bedtime. You can imagine if you've been going to bed at 1:00 AM every night, if you lay down at 10:00 PM you're probably not going to feel tired. So you wanna do that slowly over time. You also want to make sure to have a sleep environment that is quiet and dark and cool and take any extra measures you need to in order to help with this. So that might mean things like using a white noise machine, having blackout curtains, wearing an eye mask, having a fan in the room, that type of thing. You should also consider if there's additional sleep issues you're having like snoring or restless legs, because if you're experiencing medical conditions that contribute to your sleep, it's really important to talk with your doctor. Treating those is crucial, not just for your weight loss journey, but for your overall health. I do wanna take a minute to single out sleep apnea because it can be such a common issue for people who deal with obesity. The prevalence of sleep apnea in the United States adult population is about 24% in our men and 9% in women. But in people who struggle with severe obesity, it's up to 94% of men and 74% of women. That means like most men with severe obesity and three quarters of women with severe obesity may be struggling with sleep apnea. And I think of sleep apnea as the most severe form of snoring. Sleep apnea means that you actually pause breathing in the middle of the night, which then can be associated with a dip in our oxygen levels and our heart rate levels. And when this happens, your body, body startles awake in order to prevent you from dying. Basically, your body's gonna startle sometimes just slightly or other times you might fully wake up gasping for air. But either way, whether it's those little startle episodes or big startle episodes, those startle episodes are very disruptive to our sleep. People with sleep apnea are getting less time in that deep and restorative sleep because every time they enter into that deep sleep, they're aroused into a lighter form of sleep where they're less likely to pause breathing. So they're getting really, really poor quality of sleep. They may spend eight hours in bed, but the quality of their sleep is so poor. It might be as if they got four or five hours of sleep, for example. And sleep apnea is such a perfect example of that chicken and the egg situation because one of the biggest risk risk factors for sleep apnea is having an increased weight or an increased neck circumference or both. And people who struggle with both obesity and sleep apnea often have an improvement in their sleep apnea and snoring when they lose weight. But on the other hand, having sleep apnea can make it really difficult to lose weight when you're not getting good restorative sleep every night. Weight loss is a lot more challenging. I can't tell you how many patients I've had who are doing quote everything right, they're eating healthy, they're exercising, and their weight won't bulge, or they might lose weight for a period of time and hit a plateau. And if you have sleep apnea, diagnosing and treating, it can feel like a miracle because not only is it possible for you to wake up feeling refreshed, diagnosing and treating sleep apnea could be the missing piece of your weight loss, weight loss journey. And one patient I have is such a drastic and great example of the role sleep apnea can pay in weight loss. He started on a weight loss journey and he was doing great. He was eating well, he was exercising, he lost weight, but then it plateaued pretty quickly. So he and I talked and I organized for him to have a sleep study where he was diagnosed with severe sleep apnea. He was treated with sleep apnea with a CPAP machine, and I swear to you, he lost 50 pounds within months without changing anything else. He was still eating well, he was still exercising like he had already been doing, and then he added the sleep apnea treatment and the weight literally fell off. And even better, once he lost his excess weight, he actually cured himself of sleep apnea and no longer needed treatment for it. And certainly everyone isn't going to be that drastic of an example, but I share this as an example of what is possible. If you snore, please set up an appointment with your doctor to ask about further evaluation for sleep apnea. If you struggle with weight and you're not sure if you snore, ask your bed partner. And if you don't have a bed partner, consider inviting a family member or a friend over to stay the night and ask them if they notice that you snore. Learning how to improve your sleep is one of the best things you can do for not just your weight, but honestly your overall physical and mental health. I hope you've learned something today. Thank you so much for joining me today. If you're interested in learning more about me or if you live in Illinois or Virginia and would like to be a patient in my telemedicine based weight loss practice, check out my website www.sarahstombaughmd.com. That's S-A-R-A-H-S-T-O-M-B-A-U-G-H-M-D dot com. If you've enjoyed the podcast today, I'd appreciate if you subscribe and leave me a review wherever you listen to podcast and please share this with any of your friends or family who might benefit. Thanks for joining me. I look forward to seeing you next week. Bye-bye.
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